Organization Active NPI

Panther City Eye Care PLLC

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1821828666
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PANTHER CITY EYE CARE PLLC
Practice address
2902 Race St
Fort Worth, TX 76111-4104
Phone
(682) 747-6319
Fax
(817) 238-3511
NPI assigned
Aug 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julie Ervin, ODNPI 1447810080
Title
Owner
Phone
(682) 747-6319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2902 Race St
Fort Worth, TX 76111-4104

Mailing address

2902 Race St
Fort Worth, TX 76111-4104
Phone (682) 747-6319

Other names 1

  • PANTHER CITY EYE CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241226001208 TX Part B Supplier - Clinic/Group Practice 2163959594 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1821828666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2902 RACE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761114104",
            "telephone_number": "682-747-6319",
            "fax_number": "817-225-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 RACE ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761114104",
            "telephone_number": "682-747-6319",
            "fax_number": "817-238-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANTHER CITY EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-06",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-747-6319",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PANTHER CITY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PANTHER CITY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.